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HomeMy WebLinkAboutG2 Forensic Investigations - Insurance Certificate (2018)ACORO0 CERTIFICATE OF LIABILITY INSURANCE P3/21/2018 ATE (MMIDDIYYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Certificate Department NAME: p PAJC. Ext. (713)521 -9251 AI�No: (713) 521 -0125 El Dorado Insurance Agency, Inc. ADDRIESS: certificates @eldoradoinsurance.com E1 Dorado Sec Srvs Ins Agy PO BOX 66571 INSURERS AFFORDING COVERAGE NAIC# INSURERA:Crum & Forster Specialty Insurance 44520 Houston TX 77266 INSURED INSURER B: CLAIMS -MADE � OCCUR INSURER C: Guardian Alliance Investigations, LLC INSURER D: 11 S. San Joaquin Street Suite 804 INSURER E: $ 100,000 X 1 INSURER F., $ 10,000 Stockton CA 95202 COVERAGES CERTIFICATE NUMBER:BLANKET AI (1/18) REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE TADS) L SU D POLICY NUMBER MMIDI DY/YYYY MMIDDY/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS -MADE � OCCUR DAMAGE PREM SESOE. ocicu".nce $ 100,000 X MED EXP (Any one person) $ 10,000 Professional Liability GLO- 501152 1/2/2018 1/2/2019 PERSONAL &ADV INJURY $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 5,000,000 X POLICY PRO- JECT Y LOC PRODUCTS - COMP /OPAGG $ 5,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ NON -OWNED HIRED AUTOS AUTOS 1$ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N I PER OTH- STATUTE ER __1 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? NIA E.L. DISEASE - EA EMPLOYE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT I $ DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The General Liability policy includes a blanket automatic additional insured endorsement that provides additional insured status to the certificate holder only when there is a written contract between the named insured and the certificate holder that requires such status. CERTIFICATE HOLDER CANCELLATION leeann.mcphillips @cityofgi SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF GILROY THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 7351 ROSANNA ST. ACCORDANCE WITH THE POLICY PROVISIONS. GILROY, CA 95020 AUTHORIZED REPRESENTATIVE R.L. Ring, Jr. /AW08��' _ ACORD 25 (2014101) INS025 (201401) ©1988 -2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: GLO- 501152 COMMERCIAL GENERAL LIABILITY CG 20 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Locations Of Covered Operations Any person or organization you have agreed in a written contract to add Locations and operations covered under this policy when required by as an additional insured on your policy provided the written contract is written contract executed prior to the "bodily injury ", "property executed prior to the "bodily injury", "property damage" or "personal and damage" or "personal and advertising injury" advertising injury" Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or However: 2. That portion of "your work" out of which the injury or damage arises has been put to its 1. The insurance afforded to such additional intended use by any person or organization insured only applies to the extent permitted by other than another contractor or subcontractor law; and engaged in performing operations for a 2. If coverage provided to the additional insured is principal as a part of the same project. required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20 10 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 2 C. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. Page 2 of 2 C Insurance Services Office, Inc., 2012 CG 20 10 04 13 0 OP ID: SMP ACORO CERTIFICATE OF LIABILITY INSURANCE D0212 3 /201 8Y) 02/23/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Alliance Mgt. & Insurance Sery 355 Via Vera Cruz #7 CA Agent/Broker Lic# 0737966 San Marcos, CA 92078 Michelle A. Nowell NAME: Michelle A Nowell PHONE 760 -471 -7116 FAx ac No Et l: A/c No): 760- 471 -9378 AI DRess: mnowell@amiscorp.com PRODUCER GUARD01 CUSTOMER ID #: INSURER(S) AFFORDING COVERAGE NAIC # INSURED Guardian Alliance INSURER A: Acceptance Casualty Ins Comp 10349 Investigations, LLC Colleen Zorzi INSURER 6 X COMMERCIAL GENERAL LIABILITY 11 S. San Joaquin St 8th FL INSURER C: 02/23/2019 DAMAGE TO RENTED PREMISES Ea occurrence) $ 100,000 Stockton, CA 95202 INSURER D: INSURER E: MED EXP (Any one person) INSURER F: PERSONAL & ADV INJURY $ 1,000,000 COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL SUB POLICY NUMBER /YYYY MMIDDY MMIDDIIYYYY LIMITS Stockton, CA 95202 GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CP00962521 02/23/2018 02/23/2019 DAMAGE TO RENTED PREMISES Ea occurrence) $ 100,000 CLAIMS -MADE FKI OCCUR MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 X Errors & Omission GENERALAGGREGATE $ 5,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OPAGG $ 1,000,000 $ X POLICY JEOT- L A AUTOMOBILE LIABILITY ANY AUTO CP00962521 02/23/2018 02/23/2019 LIMIT CO BINEDt) accident) S 1,000,000 BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ X SCHEDULEDAUTOS HIREDAUTOS PROPERTY DAMAGE (PER ACCIDENT) $ S X NON - OWNEDAUTOS $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DEDUCTIBLE $ $ RETENTION S WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR /PARTNER /EXECUTIVE STATU- OTH- TORWC Y LIMITS I I ER E.L. EACH ACCIDENT $ OFFICER /MEMBER EXCLUDED? ❑ NIA (Mandatory in NH) E.L. DISEASE - EA EMPLOYE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Proof of insurance. This certificate is void if altered. Certificate Holder may be added upon request. Investigations, CA -- CERTIFICATE HOLDER CANCELLATION © 1988 -2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Guardian Alliance Investigations, LLC 11 S. San Joaquin St 8th FL AUTHORIZED REPRESENTATIVE Stockton, CA 95202 (L U _ _ ft>R!1 © 1988 -2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD OP ID: SMP A4COR1j CERTIFICATE OF LIABILITY INSURANCE D 0 2/12323 /122018 018Y) 0 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Alliance Mgt. & Insurance Sery 355 Via Vera Cruz #7 CA Agent/Broker Lic# 0737966 San Marcos, CA 92078 Michelle A. Nowell CONTACT Michelle A Nowell PHONE FAX A/c No ENE 760 -471 -7116 'C, No ; 760- 471 -9378 ADDRESS: mnowell@amiscorp.com PRODUCER GUARD01 CUSTOMER ID #: INSURER(S) AFFORDING COVERAGE NAIC # EACH OCCURRENCE INSURED Guardian Alliance INSURER A: Acceptance Casualty Ins Comp 10349 Investigations, LLC Colleen Zorzi INSURER B PERSONAL & ADV INJURY $ 1,000,000 11 S. San Joaquin St 8th FL INSURER C: $ 5,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRO LOC X POLICY PRODUCTS - COMP /OPAGG Stockton, CA 95202 INSURER D: $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIREDAUTOS NON - OWNEDAUTOS INSURER E: INSURER F: 02123/2018 02/23/2019 COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY MM/DDY /YYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE Fx_1 OCCUR X Errors & Omission X Investigative Services CP00962521 02/23/2018 02/23/2019 EACH OCCURRENCE $ 1,000,000 DAMAGE FQ PREMISES Ea occurrence) c$ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERALAGGREGATE $ 5,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRO LOC X POLICY PRODUCTS - COMP /OPAGG $ 1,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIREDAUTOS NON - OWNEDAUTOS CP00962521 02123/2018 02/23/2019 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) S PROPERTY DAMAGE (PER ACCIDENT) $ X X $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNER/EXECUTIVE OFFICER /MEMBER EXCLUDED? ❑ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA WC STATU- OTH- TORY LIMITS ER E.L. EACH ACCIDENT S E.L. DISEASE - EA EMPLOYEE S E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) PI Lic #188266 State of California Bureau of Security and Investigative Services is named as additional insured and shall be notified of changes to limits or cancellation to the policy. Investigations, CA -- CFRTIFICATE HOLDER CANCELLATION CALIC -2 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. State of California Bureau of Security and Investigative Services AUTHORIZED REPRESENTATIVE P O Box 989002 West Sacramento CA 95798 -0550 © 1988 -2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: CP00962521 COMMERCIAL GENERAL LIABILITY CG 20 26 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE I Insu Automatic Status Included Where Required by Written Contract. All Where Required by Written Contract. Section II - Who Is An Insured is amended to in- clude as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: A. In the performance of your ongoing operations; or B. In connection with your premises owned by or rented to you. CG 202607 04 © ISO Properties, Inc., 2004 Page 1 of 1 ❑ 2/13/2018 WC declarations page.jpg Workers' Compensation and Employers Llabi6ty Insurance Policy EMPLOYERS ASSURANCE CO. Policy Number From ollcy Pelro A Stock Company EIG 2602101 00 02/08//g2Iaa0dd18 02/08/2019 I^swod ans slated gedr Time at the address of the ein Transaction POLICY DECLARATIONS NCCI Carrier # 36870 WCIRB CARRIER# 00919 PRIOR POLICY NUMBER NEW 1. _Named Insured and Address Agent GUARDIAN ALLIANCE INVESTIGATIO RISK EXCHANGE INS SVCS INC I 0000969 11 S SAN JOAQUIN ST STE 804 VENTURE STOCKTON CA 95202 PO BOX 192 CUMBERLAND, RI 02864 Telephone: 8773227399 Customer # Carrier # F823188323 EIN # Risk ID # Entity of Insured 36870 LIM LIABILITY CO Additional Locations: 2. The Policy Period is from 02/08/2018 to 02/08/2019 12:01 a.m. Standard Time at the Insured's mailing address. 3. A. Workers Compensation Insurance: Part ONE of the policy applies to the Workers Compensation Law of the states listed here: CA B. Employers Liability Insurance: Part TWO of the policy applies to work in each state listed in Item 3A. The limits of our liability under Part TWO are: Bodily Injury by Accident $ 1,000,000 each accident Bodily Injury by Disease $ 1,000,000 policy limit Bodily Injury by Disease $ 1,000,000 each employee C. Other States Insurance: Part THREE of the policy applies to the states, if any, listed here: All states except AK, AR, DE, HI, ME, ND, NH, OH, RI, SD, VT, WA, WV, WY and states listed in item 3.A. D. This policy includes these endorsements and schedules: See attached schedule. 4. The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates, and Rating Plans. All information required below is subject to verification and change by audit. SEE EXTENSION OF INFORMATION PAGE Minimum Premium $ 750 Assessments and Taxes $ ❑ This is a Three Year Fixed Rate Policy Premium Adjustment Period: M Annual; Countersigned this Day of Issued Date: 02/08/2018 Expense Constant $ 220 Premium Discount $ Total Estimated AnnualPremium $ 5,895 ❑ Semiannual; ❑ Quarterly; ❑ Monthly Authorized Representative Issuing Office EMPLOYERS ASSURANCE CO. 500 NORTH BRAND BLVD., SUITE 700 GLENDALE, CA 91203 -3916 Issued Date 02/08/2018 INSURED COPY WC990630 (5/98 Ed.) Page 1 of 2 https: //m ail.google.com /mail /u /1 / ?tab= wm #in box/ 16191 a50f866865b ?projector =1 &message Partld =0.1 1 /1 `•Poc.k-e Bureau. 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STOCKTON, eA 4i 2;* 02 -'P1188266' -- 1-2/31'"/2019' - 9665-- Re�eipt-No. °GUARDIAN ALLIANCE-INVESTCGATIONS,'L'LC Signawre r This; is your RECEIPT. .. Please save for•your records. „ , - - - - ... :'a ?BA:CEffiT60P.011:117• . Z0ZS6 VO 'NODWIS 400000 1709# 1S Ninovo NVS S b 6 GUVM NOMM N3n31S 2006 -861-96 VO O1N�IWV�iOVS 1S8M 200686 X08 Od S30WJ8S 9AIlVJIlS3nNI aNV Affil inoO is jO nvEizino rosoovrzt sooao �sasootoocztnoz- sze000 toe000aor